Not many people get excited about reading research except other doctors and researchers and the fact that you've come to this page has impressed me.  No site of this type would be complete without including some of the supporting literature that has been done that shows Chiropractic works.

Research supports chiropractic as THE primary mode of health care for lower back pain.

In recent years, numerous independent researchers and various government agencies have conducted studies which focus on the efficacy, appropriateness and cost-effectiveness of chiropractic treatment. Several of these important studies are listed below.

There is evidence that chiropractic is effective in certain situations. Seven studies found that:

The Manga Report: Chiropractic was the treatment of choice for low back pain, according to the Manga Report, a 1993 study by the Ontario Ministry of Health in Canada that recommended all low back pain patients be referred to chiropractors. "...for the management of low-back pain, chiropractic care is the most effective treatment, and it should be fully integrated into the government's health care system." "...spinal manipulation applied by chiropractors is shown to be more effective than alternative treatments for low-back pain." "...injured workers ... diagnosed with low-back pain returned to work much sooner when treated by chiropractors than by physicians." "The overwhelming body of evidence shows that chiropractic management of low-back pain is more cost effective than medical management, and that many medical therapies are of questionable validity or are clearly inadequate ... Chiropractic manipulation is safer than medical management of low-back pain." "There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors... Users of chiropractic care have substantially lower health care costs, especially inpatient costs, than those who use medical care only."

The Rand Corp Study: Spinal manipulation was an effective treatment for low back disorders according to a 1991 report by the RAND Corp., done by a panel of independent experts who surveyed existing studies.

British Medical Journal: Chiropractic medicine was significantly superior to traditional medical care, as measured by pain relieved, time off from work and money spent on treatment, British researchers discovered after a 10 year study that appeared in the June 1990 British Medical Journal.

The Florida Study: Shorter Disability and Lower Related Costs: Temporary total disability for chiropractic patients was found to be 51.3 percent shorter than for patients receiving standard medical care. The direct costs of chiropractic physician services were an average of 58.8 percent lower than the corresponding cost for medical doctors. The estimated average total cost of care was 95.3 percent higher for medical patients than for chiropractic patients.

The Utah Study: Chiropractic is Cost Effective: Compensation costs for work time lost were $68.38 for patients who received chiropractic care, compared to $668.39 for patients who received standard, non-surgical medical treatment. The number of work days lost under medical care was nearly 10 times higher with 20.7 days lost under medical care and only 2.4 days lost under chiropractic care.

	The Meade Study: Chiropractic Offers Long-Term Benefits: This study concluded, "For patients with low-back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison to hospital outpatient management."
	Koes' Clinical Trial: The Positive Results if Chiropractic are Lasting: Manipulative therapy (chiropractic) and physiotherapy were compared as treatments for persistent back and neck complaints. After 12 months, the manipulative therapy group showed greater improvement in the primary complaint with fewer visits.
	The New Zealand Report: This research studied cost effectiveness, chiropractic education and training, safety issues and patient satisfaction. This 377 page document concluded that including chiropractic would have a positive influence on the health of the country.

The United States Agency for Health Care Policy Research (AHCPR) Study: Published in 1994, this five year study concluded that relief of back pain can be accomplished most safely with nonprescription medication and/or spinal manipulation.

Patient Disability Comparison  A 1992 article in the Journal of Family Practice reported a study by D.C. Cherkin, Ph.D., which compared patients of family physicians was significantly higher (mean 39.7) than for patients managed by chiropractors (mean 10.8)." A related editorial in the same issue referred to risks of complications from lumbar manipulation as being "very low."

Oregon Workers' Compensation Study A 1991 report on a workers' compensation study conducted in Oregon by Joanne Nyiendo, Ph.D., concluded that the median time loss days (per case) for comparable injuries was 9.0 for patients receiving treatment by a doctor of chiropractic and 11.5 for treatment by a medical doctor.

Stano. Cost Comparison Study A study by Miron Stano, Ph.D., reported in the June 1993 Journal of Manipulative and Physiological Therapeutics involved 395,641 patients with neuromusculoskeletal conditions. Results over a two-year period showed that patients who received chiropractic care incurred significantly lower health care costs than did patients treated solely by medical or osteopathic physicians.

Saskatchewan Clinical Research Following a 1993 study, researchers J. David Cassidy, D.C., Haymo Thiel, D.C., M.S., and W. Kirkaldy-Willis, M.D., of the Back Pain Clinic at the Royal University Hospital in Saskatchewan concluded that "the treatment of lumbar intervertebral disk herniation by side posture manipulation is both safe and effective."

Wight Study on Recurring Headaches A 1978 study conducted by J.S. Wight, D.C., and reported in the ACA Journal of Chiropractic, indicated that 74.6% of patients with recurring headaches, including migraines, were either cured or experienced reduced headache symptomatology after receiving chiropractic manipulation.

1991 Gallup Poll A 1991 demographic poll conducted by the Gallup Organization revealed that 90% of chiropractic patients felt their treatment was effective; more than 80% were satisfied with that treatment; and nearly 75% felt most of their expectations had been met during their chiropractic visits.

1990 British Medical Journal Report A study conducted by T.W. Meade, a medical doctor, and reported in the June 2, 1990, British Medical Journal concluded after two years of patient monitoring, "for patients with low-back pain in whom manipulation is not contraindicated, chiropractic almost certainly confers worthwhile, long-term benefit in comparison with hospital outpatient management."

Virginia Comparative Study A 1992 study conducted by L.G. Schifrin, Ph.D., provided an economist assessment of mandated health insurance coverage for chiropractic treatment within the Commonwealth of Virginia. As reported by the College of William and Mary, and the Medical College of Virginia, the study indicated that chiropractic provides therapeutic benefits at economical costs. The report also recommended that chiropractic be widely available form of health care.

1992 America Health Policy Report A 1992 review of data from over 2,000,000 users of chiropractic care in the U.S., reported in the Journal of American Health Policy, stated that "chiropractic users tend to have substantially lower health care costs," and "chiropractic care reduces the use of both physician and hospital care."

1985 University of Saskatchewan Study In 1985 the University of Saskatchewan conducted a study of 283 patients "who had not responded to previous conservative or operative treatment" and who were initially classified as totally disabled. The study revealed that "81% ... became symptom free or achieved a state of mild intermittent pain with no work restrictions" after daily spinal manipulations were administered.

Thanks to:
Dr. Charles A. Maurer, (417) 889-2225, for the compilation of this material.

For more information about the studies cited here, contact:

Foundation of Chiropractic Education and Research
P.O. Box 4689
Des Moines, Iowa 50306-4689
Phone (800) 622-630

What Medical Doctors Say About Chiropractic

Chiropractic treatment for a variety of neuromusculoskeletal conditions is gaining wider acceptance among the medical profession. Because students of chiropractic spend significantly more time studying the spine than do medical students, many medical doctors recognize the value of chiropractors as the appropriate source for diagnosis of and first line of treatment for functional disorders of the entire musculoskeletal system.

	M.D.s now categorize chiropractic manipulation with the highest rating: "Generally accepted, well-established and widely used." Spine, 1991. North American Spine Society.
	"A majority of family physicians (in Washington) admitted having encouraged patients to see a chiropractor, and two-thirds indicated a desire to learn more about what chiropractors do." The Journal of Family Practice, 1992. "Family Physicians and Chiropractors: What's Best for the Patient?"
	"Our trial showed that chiropractic is a very effective treatment, more effective than conventional hospital outpatient treatment for low-back pain ... particularly in patients ... who have severe problems." T. W. Meade, M.D.
	"The only difference that I can see is that the patients at John F. Kennedy get chiropractic manipulations. And in my experience, the patients at J.F.K. almost without fail get out of the hospital in a week. At Lutheran, it usually takes, oh, not uncommonly, 14 days." Per Frietag, M.D., an orthopedic surgeon, on why he prefers to admit his patients with back pain to John F. Kennedy Hospital, which has staff chiropractors, rather than Lutheran General, which does not have staff chiropractors.
	"Manipulative medicine is no longer a taboo topic." Norton Hadler, M.D., self-described "cantankerous doctor who would have never dealt with manipulation in the past," professor of rheumatology, University of North Carolina Medical School at Chapel Hill, Time Magazine, 1991.
	"Ten years ago if you practiced manipulation ... you couldn't get published and were never invited to meetings. Now I can't keep up with the invitations." Neurologist Scott Haldeman. M.D.. D.C.. New York Times. 1991.
	"...one of the unexpected findings ...looks as though the treatment that the chiropractors give does something that results in a very long-term benefit." T. W. Meade, M.D., CBC Radio.

Cost Effectiveness of Chiropractic

Chiropractic treatment of back pain is a perfect example of how health care expenditures can be reduced while in fact increasing the quality of care. Not only is chiropractic treatment significantly less costly than treatment managed by a medical doctor, but because chiropractic care can get workers back on the job more quickly, it can save business millions of dollars in lost productivity.

Cost/Quality Analysis

	"The overwhelming body of evidence shows that chiropractic management of low-back pain is more cost effective than medical management, and that many medical therapies are of questionable validity or are clearly inadequate ... Chiropractic manipulation is safer than medical management of low-back pain." The Manga Report, 1993.
	"There would be highly significant cost savings if more management of low-back pain was transferred from physicians to chiropractors... Users of chiropractic care have substantially lower health care costs, especially inpatient costs, than those who use medical care only." The Manga Report, 1993.

Mean Compensation Costs

"The mean compensation cost (not treatment costs) paid out by the Utah Worker's Compensation Board for patients treated by medical doctors was $668.39; the mean compensation cost paid for patients treated by chiropractic was only $68.38." Journal of Occupational Medicine, 1991. "Cost per Case Comparison of Back Injury Claims for Chiropractic vs. Medical Management for Conditions with Identical Diagnostic Code."

Medical Payments

	Total medical costs for back-related injuries cost the Utah Worker's Compensation Board an average of $1,665.43 per case; chiropractic costs for similar diagnoses cost only $775.30. D.C.. Tracts, 1989. "Cost per Case Analysis of Utah Industrial Back Injury Claims: Chiropractic Management vs. Medical Management for Diagnostically Equivalent Conditions."
	Medical payments for back-related injuries cost the Florida Worker's Compensation Board $1,100 per case; chiropractic treatment for similar diagnoses cost only $558. ACA Journal of Chiropractic, 1988. "An Analysis of Florida Worker's Compensation Medical Claims for Back-Related Injuries."

Comparison of Compensation Days

Of 1,996 low-back pain cases studied, patients receiving chiropractic treatment averaged 6.26 compensation days compared to 25.56 compensation days for medical patients. Chiropractic Journal of Australia, 1992. "Mechanical Low-Back Pain: A Comparison of Medical and Chiropractic Management."

 

The Av-Med Study - This study included 80 patients, each of whom was previously treated by a medical doctor and subsequently referred to the Silverman Chiropractic Center. Of these 80 patients, 21 % had been diagnosed with disc problems, 5% received emergency room treatment and 12% had been diagnosed as requiring surgery.

Following chiropractic treatment, no surgery was required. 86% needed no further treatment at all. And the projected savings on the patient study group was approximately $250,000. The Av-Med Study, 1993.

Chiropractic's Increase in Popularity

Because chiropractic treatment of lower back pain is often more successful than medical treatment, patient satisfaction with chiropractic care is generally higher. As these successes mount, positive word-of-mouth spreads. Today, the popularity of chiropractic is at an all-time high.

	Nearly 30% of the U.S. population, aged 18 and older, have used chiropractic. The Gallup Organization, 1991.
	Nine of ten chiropractic users felt their treatment was effective. The Gallup Organization, 1991.
	58% of those using chiropractic considered it an essential part of their Heath insurance package. The Gallup Organization, 1991.
	"Chiropractic patients were three times more satisfied with their care than patients of family practice physicians." Western Journal of Medicine, 1989. "Patient Evaluations of Low-Back Pain Care."
	"Chiropractors are now accepted as a legitimate healing profession by the public and by an increasing number of physicians." The Manga Report, 1993.
	"Chiropractic is a growing component of the health care sector, and it is widely used by the population." The College of William and Mary, Williamsburg, Virginia, and Medical College of Virginia, Richmond, Virginia, January 1992. "Mandated Health Insurance Coverage for Chiropractic Treatment: An Economic Assessment, With Implications for the Commonwealth of Virginia."
	ACA Journal of Chiropractic, 1989. Patient Evaluations of Care from Family Physicians and Chiropractors:

Patient Evaluations of Care:		Chiropractor	Family M.D.
	Restricted for more than one week	17.0 %	48.0 %
	Mean number of days incapacitated after first visit	10.8 %	39.7 %
Patient Perception of Doctor's Confidence In:
	Diagnosing and treating low-back pain	60.0 %	23.0 %
	Very satisfied	66.0 %	22.0 %